y r e V
A Modern Review of Cataract (1824) A Humorous Poster by Media MICE, based loosely on the full text of Med Chir Rev. 1824;1(2):396-413.*
Introduction
Symptoms, and diagnosis by candle
On the operations posterior to the iris
The vast importance of the subject [cataract] requires no proof. For the erroneous and absurd opinions that were once entertained, both upon the nature and treatment of cataract, we must refer to systematic works upon the subject. Our pages may be more profitably occupied by a condensed statement of what we do know, than by an erudite and lengthened detail of what our ancestors did not know. To prevent the constitutional form of cataract is not in our power. We cannot foresee its commencement. Persons of all ages are subject to it; no particular temperament enjoys an exemption from cataract, nor has it been found to prevail in those of any known constitution, disposition, or idiosyncrasy.
There is infrequently an appearance of black specs, of dust, flies, or cobwebs floating before the eyes; flashes of light sometimes dart across them; the candle seems surrounded by burning circles or rings, of divers colours.
1st. Simple depression, consisting in dislodging the opaque lens from its natural situation, and placing it in the vitreous humour, so far from, and under the level of pupil that the vision may not be prevented. It is fairly divisible into three parts: 1. Introduction of the needle. 2. Placing it on the anterior surface of the lens. 3. Removing the lens out of and below the axis of vision.
It is not from syphilis Mr. Guthrie [another ophthalmic nobleman] believes that neither scrofula nor syphilis have any share in the production of the disease, unless under particular circumstances, when it is no longer idiopathic. However frequent and severe may have been the attacks of syphilis, no facts have yet been adduced to prove the subjects of them have been particularly liable to cataract. [Warning: Don’t take this poster seriously!]
Abstain from animal food prior to operation, and take a laxative Mr. Guthrie is by no means sanguine in his expectations of curing even incipient cataract by medicinal means. The patient being temperate, and in good health, will need only to abstain from animal food for a couple of days before the operation, and to take an aperient.
Therapies It would be no purpose to detail the many progressive improvements which have been suggested by the gradual detection of erroneous principles.
[Mr Guthrie] is of the opinion that the choice of operation, in able hands, is nearly a matter of indifference. He prefers, however, the operation of reclination… intended for hard cataracts only.
After-treatment The operation having been completed, examinations to ascertain whether the patient can see are useless and improper. The admission of light is to be prevented, a suitable bandage applied, and a low diet observed for several days. On the third or fourth day, the eye may be opened, with the back turned to the light. Violent vomiting sometimes comes on immediately. Opium, saline draughts, and camphor should be given to allay this distressing symptom. *Cataract. Med Chir Rev. 1824;1(2):396-413.